As craving is central to many models of substance use, abuse and relapse, studies of the role of craving (urge to use) in drug seeking behavior are important for refining theories of addiction and developing effective treatment innovations. The long-term objective of this program of research is to increase knowledge about a range of psychological and behavioral processes involved in maintaining cocaine use and abuse so as to develop more effective treatment approaches for cocaine abuse. The overall objective of this application is to add to the knowledge base about determinants and consequences of urges to use cocaine. This project is developed on the foundation of many years of theoretically driven similar research conducted with alcoholics and smokers about the determinants of urges and their role in treatment outcome. The primary specific aims of the present application are: 1) To determine the extent to which self-reported urge to use cocaine during a cocaine risk assessment on admission to treatment is a function of pretreatment drug use and other individual differences including cocaine use patterns (duration, frequency, route of administration, problem severity), other drug use (alcohol diagnosis, frequency of alcohol use, frequency of other drug use), expected effects of cocaine, and gender, race, age or antisocial personality diagnosis. 2) To determine the extent to which amount of urge to use cocaine reported in a cocaine risk assessment on admission to treatment is a predictor of treatment attrition and of treatment outcome at 3 and 6 month follow-ups while controlling for pretreatment cocaine use variables. Secondary specific aims are: 3) To determine the extent to which different cocaine relapse precipitants are differentially associated with urges to use cocaine reported in the precipitating situation. 4) To investigate retrospectively whether the rate of implementing various urge coping strategies differs at follow up as a function of relapsed versus abstinent status. Cocaine abusers (150 participants) will be recruited from a substance abuse partial hospital treatment program to complete a battery of assessments within the first week of admission. All will receive interviews in person 3 and 6 months after discharge from the partial hospital program to determine frequency of cocaine use and time to first use, situations that precipitated relapse, and skills reported for coping with urges to use. Results will be used to add to theoretical understandings of cocaine abuse and relapse, and may provide information useful for developing future treatment programs.
